Today’s post reflects on a 1959 trial concerning “fetal distress”. It highlights findings that meconium was a critical indicator of poor outcomes, while abnormal fetal heart rates weren’t reliably predictive. Should we be reevaluating current obsessions with CTG use and focusing on alternative clinical markers?
In a trial comparing fetal blood sampling to digital fetal scalp stimulation for assessing fetal wellbeing, recruitment fell short, concluding early after just 534 participants. Despite showing a significantly lower caesarean section rate with scalp stimulation, the small sample limits the findings. The irony of guidelines undermining evidence development is discussed.
A comprehensive literature review by researchers in the UK examined the safety of CTG monitoring in maternity care, identifying prominent system-level issues, including unsafe organizational cultures and inadequate staffing. It is import to focus on staffing, supportive environments, and respectful care to improve outcomes rather than unproven practices.
Informed consent is a critical principle in healthcare. A recent Australian survey revealed that many women lacked sufficient information and choice about fetal monitoring methods. Only 35% reported being asked for consent. This highlights a significant issue in maternity care, and it is well past time it was addressed.
A recent review examined the relationship between abnormal heart rate patterns in CTG monitoring and various neonatal outcomes. While some links were identified, particularly with hypoxic ischaemic encephalopathy, overall connections were weak. The evidence suggests CTG monitoring may not be as clinically useful as presumed, prompting calls for alternative monitoring methods.
The POOL study (more information is here if you haven’t been following along with this series) is simply the latest in a long series of studies examining aspects of safety relating to the use, or not, of water immersion at birth. Where does the POOL study evidence fit with what was already known from earlier research? Does it provide something new and controversial, or does it reinforce where the evidence […]
This week I’m returning to an exploration of the literature about water birth and the perineum. The recently published paper by Sanders and colleagues (2024, in press) has already generated two letters to the editor. I want to start by looking at their criticisms and considering their validity, before making some conclusions about what I think the POOL study can teach us. Letter number 1 The first of the letters […]
The past decade has seen quite a lot written about whether giving birth in water is good or bad for women’s perineums. The UK seems to have been the hotspot for these discussions. In today’s blog post, I’m going summarise a new piece of research that has kicked off another round of letters to the editor. How was the research done? This new, just published trial is the POOL cohort […]
Last week I posted about a literature review that summarised 47 years of research about women’s experiences of labour. The same research team responsible for that paper, has also just recently published new Australian research (Fox et al., 2024) describing women’s current experiences with fetal monitoring in labour. The paper has been published in an open access journal, so you are able to read the full paper yourself. If you […]
Much of the focus in research about fetal monitoring in labour has been on outcomes for the fetus / baby. Not as much has looked at women’s outcomes, and even less has looked at what women say about their experiences with CTG monitoring. But there has been some research, and a team of researchers recently pulled it all together in the one place (Murray et al., 2024). Murray and colleagues […]
Birth Small Talk 